title: Sex and intimacy among patients with implantable left-ventricular assist devices.
abstract: OBJECTIVE
  Left-ventricular assist devices (LVADs) sustain and improve the quality of life of people living with an advanced stage of heart failure. Past research focused on the development and advancement of LVAD technology, complications, and survival rates. Limited research addressed the psychosocial aspects of living with an LVAD, yet research related to sexual functioning and intimacy is lacking. The purpose of this study was to explore and describe sex and intimacy among adults living with an LVAD.
  
  
  METHODS
  We used an interpretive phenomenological study to explore the experiences of adults living with a long-term implantable LVAD, including the effect of the LVAD on their intimate and sexual functioning. Semistructured interviews were conducted with 7 men and 2 women, 31 to 70 years of age, who had lived with the LVAD at home for at least 3 months. Interviews were audiorecorded and transcribed. The wholistic and selective approach by van Manen (Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. Albany, NY: SUNY Press; 1990) guided the analysis and interpretation of the transcribed interviews. Data were organized and coded into words and phrases using qualitative software.
  
  
  CONCLUSIONS
  Three themes emerged from the data: (a) improved sexual relations with LVAD, (b) sexual adjustment, and (c) nonsexual intimacy. The themes identified were consistent with the concept of normalcy from the theory of self-care. Participants reported that as the LVAD improved their overall health, their sexual functioning also improved. Participants also reported an increased sense of connectedness and intimacy with their partners even in the absence of sexual intercourse. Participants discussed ways in which they continued to develop intimate relationships even in the presence of limitations in structural and functional integrity. The knowledge derived from this study can be used as a guide for healthcare providers in counseling LVAD recipients on psychosocial and sexual health essential for achieving an optimum quality of life.
authors.affiliation: Wayne State University College of Nursing, Detroit, Michigan 48202, USA. ea0017@wayne.edu
authors.forename: Linda
authors.initials: L
authors.lastname: Marcuccilli
authors.forename: Jesus Jessie
authors.initials: JJ
authors.lastname: Casida
authors.forename: Rosalind M
authors.initials: RM
authors.lastname: Peters
authors.forename: Susan
authors.initials: S
authors.lastname: Wright
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D005260:Female; D006333:Heart Failure / Q000523:psychology / Q000601:surgery; D006353:Heart-Assist Devices / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012725:Sexual Behavior; D019529:Sexuality